The QuickSort: A brief cognitive screen to detect cognitive impairment in older adults

Abstract

AbstractBackgroundSorting tests are amongst the most sensitive cognitive tests for detecting brain injury, but are rarely used to screen older adults for cognitive impairment. A recent meta‐analysis (Foran, Mathias & Bowden) found that sorting ability deteriorates in older adults who have been diagnosed with one of a number of common neurodegenerative disorders, suggesting that sorting tests may provide an alternative to cognitive screens. The QuickSort is a new test that improves on existing sorting tasks, with the manual and test stimuli freely accessible to users (Foran, Mathias & Bowden, 2020). It is quicker to administer and score, and better suited for use with older adults whose cognitive ability may be compromised.MethodA consecutive cohort of older (≥60 years) community‐dwelling adults (n=187) and hospital inpatients who were referred for a neuropsychological assessment (n=73) were administered the Mini‐Mental Status Examination (MMSE), Frontal Assessment Battery (FAB) and QuickSort (9‐stimuli, which must be sorted by color, shape & number; Total score range = 0‐18; higher scores indicate better cognition). A Cognitively‐Healthy normative subsample (n=115), screened for cognitive and psychological disorders, was formed from the community sample.ResultsThe Cognitively‐Healthy subsample completed the QuickSort within 2‐minutes, 50% had errorless performance, and 95% scored 10 or more. The likelihood of community‐dwelling older adults and inpatients (n=260) being impaired on either the MMSE or FAB, or both, increased by a factor of 3.52 for QuickSort Total scores <10 and reduced by a factor of 0.23 for scores ≥10.ConclusionMost healthy older adults complete the QuickSort quickly and easily. The QuickSort performance of a patient can be compared to their cognitively‐healthy peers in order to estimate the likelihood that they will be impaired on either the MMSE or FAB, or both. The QuickSort can also be customized for use in specific settings. The QuickSort may provide an alternative to lengthier cognitive screens (MMSE and FAB) in settings that have very limited clinical resources.